Provider Demographics
NPI:1013033216
Name:BOBINGER, MACAIRA ROONEY (DPT)
Entity Type:Individual
Prefix:
First Name:MACAIRA
Middle Name:ROONEY
Last Name:BOBINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MACAIRA
Other - Middle Name:ANN
Other - Last Name:ROONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:560 S LOOP RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3405
Mailing Address - Country:US
Mailing Address - Phone:859-301-2663
Mailing Address - Fax:859-817-7848
Practice Address - Street 1:7753 BEECHMONT AVE STE 200
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4203
Practice Address - Country:US
Practice Address - Phone:859-817-3599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.011714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000512446OtherANTHEM
OH2743446Medicaid
OHP00414962OtherMEDICARE RAILROAD
OHH248950Medicare PIN
OHP00414962OtherMEDICARE RAILROAD
OHBO4204861Medicare PIN